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Instructor Date. 2 Course Outline – Session 1 Mental Health First Aid Common mental health problems The five basic steps of mental health first aid What.

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Presentation on theme: "Instructor Date. 2 Course Outline – Session 1 Mental Health First Aid Common mental health problems The five basic steps of mental health first aid What."— Presentation transcript:

1 Instructor Date

2 2 Course Outline – Session 1 Mental Health First Aid Common mental health problems The five basic steps of mental health first aid What are substance use disorders? Symptoms and risk factors Crisis first aid for overdose Mental health first aid for substance use disorders Treatment and resources

3 3 Course Outline – Session 2 What is depression? Symptoms of depression Risk factors for depression Alcohol, drugs and depression Suicide in Canada Crisis first aid for suicidal behaviour Mental health first aid for depression Treatment and resources

4 4 Course Outline – Session 3 What are anxiety disorders? Symptoms of anxiety disorders Risk factors for anxiety disorders Alcohol, drugs and anxiety disorders Crisis first aid for panic attacks Crisis first aid for acute stress reaction Mental health first aid for anxiety disorders Treatment and resources

5 5 Course Outline – Session 4 What are psychotic disorders? Symptoms of psychotic disorders Risk factors for psychosis Alcohol, drugs and psychotic disorders Crisis first aid for acute psychosis Mental health first aid for psychosis Treatment and resources Other expressions of distress

6 6 World Health Organization Health is “a state of (complete) physical, mental and social well-being and not merely the absence of disease or infirmity.” Mental Health is “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.”

7 7 The Mental Health Continuum Maximum Mental Health Minimal Mental Disorder Minimal Mental Health Maximum Mental Disorder Diagnosis of a serious illness and poor mental health Diagnosis of a serious illness but copes well and has positive mental health No illness or disorder and positive mental health No diagnosable illness or disorder but has poor mental health

8 8 What are Mental Health Problems? A mental health problem causes major changes in a person’s thinking, emotional state and behaviour, and disrupts the person’s ability to work and carry on their usual personal relationships.

9 9 What is Mental Health First Aid? Mental Health First Aid is the help provided to a person developing a mental health problem or in a mental health crisis. The first aid is given until appropriate professional help is received or until the crisis is resolved.

10 10 The Five Basic Steps A ssess risk of suicide or harm L isten non-judgmentally G ive reassurance and information E ncourage the person to get appropriate professional help E ncourage self-help strategies

11 11 Why Mental Health First Aid? There is stigma associated with mental health problems Imagine if we treated everyone like we treated the mentally ill.

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14 14 Why Mental Health First Aid? There is stigma associated with mental health problems Mental health problems are common Many people are not well informed about mental health/problems Professional help is not always on hand People often do not know how to respond

15 15 Prevalence At least 1 in 3 Canadians will experience a mental health problem at some point in their life At least 1 in 5 Canadians will experience a mental health problem in a year In Canada 20 per cent of all sick leaves are related to mental health

16 16 Impact The economic costs of mental illnesses in Canada was estimated to be at least $14.3 billion in 1998 Mental illnesses are disabling Six of the 10 leading causes of ‘years lived with disability’ are mental health problems

17 17 The ALGEE Rap Assess situation and evaluate the risk Listen very carefully and don’t tsk tsk Give reassurance and the good info Encourage them to see appropriate pro Encourage them to use self help ideas And that is the ALGEE rap my dears!

18 18 What is a Substance Use Disorder? Using alcohol or drugs does not in itself mean that a person has a substance use disorder (SUD) Dependence on a substance Use leads to problems at work, school, home Use causes damage to health

19 19 One Standard Drink Centre for Addiction and Mental Health == Table Wine 5 oz/142 mL (12% alcohol) Regular Beer 12 oz/341 mL (5% alcohol) Spirits 1.5 oz/43 mL (40% alcohol)

20 20 Low-Risk Drinking Guidelines 0 drinks = lowest risk of an alcohol- related problem No more than 2 standard drinks on any one day Women: up to 9 standard drinks a week Men: up to 14 standard drinks a week

21 21 Long-Term Effects of Alcohol Brain Heart Lungs Liver, pancreas, stomach and intestines Genitals and reproductive system Muscles, nervous system, motor skills Skin

22 22 Other Abused Substances Tobacco Nicotine is a powerful stimulant Male smokers are twice as likely to experience impotence Spit tobacco contains more than 3,000 chemicals Withdrawal symptoms include anxiety, insomnia, restlessness Some long term effects - heart disease, stroke, cancer

23 23 Other Abused Substances Cannabis (marijuana, hashish, joints, reefers) Most widely used illegal drug in Canada About 2% of the population have problem with cannabis abuse/dependence. –More than twice as likely to suffer from an anxiety disorder or depression –More than three times the risk of suffering from psychotic symptoms

24 24 Other Abused Substances Cannabis (marijuana, hashish, joints, reefers) Adolescents using cannabis are more likely to suffer from depression, conduct problems, drinking and other drug use More frequent use of cannabis increases risk of diagnosis of schizophrenia over next 15 years

25 25 Other Abused Substances Amphetamines – a stimulant drug Examples: crystal meth, ice, speed, uppers, bennies, crank, ecstasy Amphetamines have the temporary effect of increasing energy and apparent mental alertness Users develop a tolerance and need to take more to get same effects

26 26 Other Abused Substances Amphetamines – a stimulant drug An overdose can cause delusions, hallucinations, high fever, coma, death A particular mental health risk is amphetamine psychosis or “speed psychosis” which involves symptoms similar to schizophrenia

27 27 Other Abused Substances Opioids Examples: heroin, morphine, codeine, oxycodone Effects can include pain relief, drowsiness, constipation, tiny pupils Users develop a tolerance and need to take more to get same effects Overdose can result in coma and death

28 28 Other Abused Substances Cocaine (crack, coke, C, snow, flake) A cocaine high can last from 5 minutes to 2 hours Overdose can cause seizures, strokes heart attacks, coma, death Users develop a tolerance and need to take more to get same effects

29 29 Risk Factors Family history of substance abuse Childhood abuse or neglect Acceptance of substance use (community, peer) Low parental support/monitoring Poor social skills

30 30 First Aid for Substance Use Disorders A ssess risk of suicide or harm L isten non-judgmentally G ive reassurance and information E ncourage the person to get appropriate professional help E ncourage self-help strategies

31 31 Step 1 Assess the Risk of Suicide or Harm If you determine the person has taken an overdose, follow the steps for Crisis First Aid for an Overdose If the person is not at risk, move on to Step 2 – Listen Non-Judgmentally

32 32 Crisis First Aid for an Overdose If they are unconscious: Make sure the person’s airway is clear and roll them into the recovery position Phone 911 for an ambulance Try to find out what substances were used Keep the person warm, especially if alcohol is involved

33 33 Crisis First Aid for an Overdose If the person is conscious Phone or take the person to the nearest emergency department Do not give any food or fluids Reassure the person Try to find out what substances were used Keep the person warm, especially if alcohol is involved

34 34 Step 2 Listen Non-Judgmentally Listen without interrupting Ask appropriate questions to make sure you are both clear on what is being said Listen to the word and tone of voice and watch their body language Restate what the person has said Summarize facts and feelings

35 35 Step 2 Listen Non-Judgmentally Be attentive Keep eye contact comfortable (don’t stare or avoid eye contact) Keep an open body position Sit down, even if they stand Try not to sit directly opposite (facing) the person

36 36 Step 3 Give Reassurance and Information Tell the person you want to help them Substance use disorder is a real medical condition It is a common illness Programs are available to help Often depressive and anxiety disorders underlie SUDs and can be treated

37 37 Step 4 Encourage the Person to Get Appropriate Professional Help Family doctor or physician Drug and alcohol specialists Mental health team

38 38 The Change Model Contemplation Pre-contemplation Determination/ Preparation Relapse Maintenance Action

39 39 Step 5 Encourage Self-Help Strategies Many people with a substance use disorder may also have another underlying mental health problem such as depression or anxiety. The self-help strategies for these conditions may help but should not be the main source of treatment.

40 40 Resources Alberta Alcohol and Drug Abuse Commission Centre for Addiction and Mental Health

41 41 If If you can always be cheerful If you can sleep without drugs If you can relax without alcohol If you can start the day without caffeine If you can take blame without resentment If you can resist without complaining If you can eat the same food every day without complaining and be grateful

42 42 If If you can understand when your loved ones are too busy to spend time with you If you can overlook it when those you love take things out on you when, through no fault of yours, something goes wrong Then you are almost as good as your dog

43 43 Session 2 What is depression? Symptoms of depression Risk factors for depression Alcohol, drugs and depression Suicide in Canada Crisis first aid for suicidal behaviour Mental health first aid for depression Treatment and resources

44 44 What is Depression? Clinical depression lasts at least two weeks, affects the person’s behaviour and has physical, emotional and cognitive effects. It interferes with the ability to work and have satisfying personal relationships.

45 45 Symptoms of Depression Emotions: sadness, mood swings, hopelessness, anxiety Thoughts: Self-criticism, indecisiveness, thoughts of suicide, pessimism Behaviour: Crying spells, neglect personal appearance, withdrawal, no motivation Physical: Lack of energy, sleeping too much/too little, overeating/loss of appetite

46 46 Depression in the Workplace Decreased productivity Morale problems Lack of co-operation Safety problems Absenteeism Complaints of being tired, having aches/pains Alcohol and/or drug abuse

47 47 Bipolar Disorder (Manic Depression) Bipolar disorder is characterized by extreme mood swings A person has periods of depression and mania with periods of ‘normal’ mood in between A person must have episodes of both depression and mania to be diagnosed

48 48 Symptoms of Bipolar Disorder Depression Mania –Increased energy and over activity –Elated mood –Needing less sleep than usual –Irritability –Rapid thinking and speech –Lack of inhibitions –Grandiose delusions –Lack of insight

49 49 Risk Factors for Depression Break up of relationship or living in conflict Having a baby Job loss, unsuccessful job hunting Long term illness or disability or caring for someone with illness/disability Being a victim of a crime Alcohol or drug abuse

50 50 Risk Factors for Depression Side effect of medications or drugs Stress from another mental disorder Hormonal changes Lack of exposure to bright light in winter Family history of depression Previous episodes of depression Difficult childhood (abuse, neglect)

51 51 Suicide in Canada About 4,000 Canadians die by suicide each year In 2001, there were 3.5 suicides among men for every suicide among women. People in their 40s accounted for almost one in four suicides. Deaths by suicide surpassed deaths by motor vehicle accidents in that same year.

52 52 Suicide Rates by Province Per 100,000 population, Alberta Saskatchewan Manitoba Ontario Quebec New Brunswick Nova Scotia Prince Edward Island Canada British Columbia

53 53 First Aid for Depression A ssess risk of suicide or harm L isten non-judgmentally G ive reassurance and information E ncourage the person to get appropriate professional help E ncourage self-help strategies

54 54 Step 1 Assess the Risk of Suicide or Harm If you determine the person is at risk, follow the steps for Crisis First Aid for Suicidal Behaviour If the person is not at risk, move on to Step 2 – Listen Non-Judgmentally

55 55 Crisis First Aid for Suicidal Behaviour 1.Engage the person in serious conversation about how they are feeling 2.Determine if the person has thoughts of suicide 3.Explore and assess the risk further 4.Find out about prior suicidal behaviour 5.Find out about their supports

56 56 Crisis First Aid for Suicidal Behaviour 6.Ensure the person is not left alone 7.Seek additional help 8.If they are consuming alcohol or drugs, try to ensure they do not take more 9.Try to ensure they do not have ready access to some means to take their life 10.Encourage the person to talk 11.Ensure your own personal safety

57 57 Self Care Supporting a suicidal person can be unsettling and stressful Do not underestimate the effect on your own well-being Find ways of reducing the immediate stress (exercise, relaxation techniques, sleep) Find someone to talk to about your experience

58 58 Step 2 Listen Non-Judgmentally Listen to the person without judging. Do not be critical of the person. Do not express frustration with the person for having these symptoms. Do not give glib advice such as ‘pull yourself together’. Avoid confrontation unless necessary to prevent harmful acts.

59 59 Step 3 Give Reassurance and Information Depression is a real medical condition Depression is a common illness Depression is not a weakness or character defect Depression is not laziness Effective help and treatments are available

60 60 Step 4 Encourage the Person to Get Appropriate Professional Help Community-based care Family doctor or physician Counsellors and clinical psychologists Psychiatrists

61 61 What Helps for Depression? Very severe depression only Electroconvulsive therapy (ECT) Adults Adolescents Antidepressants RatingMedical Treatments Very good evidence Good evidence Promising treatment

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64 64 What Helps for Depression? Reading depression self-help books based on CBT Psychodynamic psychotherapy Interpersonal psychotherapy Cognitive behaviour therapy (CBT) RatingPsychological Treatments

65 65 Ten Common Thinking Distortions 1.Black and white thinking 2.Setting unrealistic expectations 3.Selective thinking 4.Converting positives into negatives 5.Over generalizing 6.Exaggerating unpleasantness 7.Catastrophizing 8.Personalizing 9.Mistaking feelings for facts 10.Jumping to negative conclusions

66 66 Step 5 Encourage Self-Help Strategies Self-help strategies have proven therapeutic effects They also help people to feel they are regaining control of their lives

67 67 What Helps for Depression? Massage therapy Relaxation therapy Yoga breathing exercises Winter depression Non-seasonal depression Light therapy Exercise RatingLifestyle & Alternative Treatments

68 68 What Helps for Depression? Alcohol avoidance – for people with drinking problems Folate St John’s wort* Acupuncture RatingLifestyle & Alternative Treatments * St John’s wort should not be taken with antidepressants. This herb has interactions with a number of prescribed medications.

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74 74 Resources Refer to MHFA Canada Manual Section 2, page 11

75 75 Session 3 What are anxiety disorders? Symptoms of anxiety disorders Risk factors for anxiety disorders Alcohol, drugs and anxiety disorders Crisis first aid for panic attacks Crisis first aid for acute stress reaction Mental health first aid for anxiety disorders Treatment and resources

76 76 What are Anxiety Disorders? An anxiety disorder differs from normal anxiety Anxiety disorders are more severe, they last longer and they interfere with work or relationships There are several types of anxiety disorders – symptoms will vary.

77 77 Mind Racing? Vision strange or blurry? Possible sleep disturbance? Heart racing, palpitations? Difficulty swallowing? Dizzy, disoriented, lightheaded? Trembling? Sweating or shivering? Wanting to run? Feeling breathless, breathing fast & Shallow? Nausea, lack of appetite? Restless? Jelly-like legs?

78 78 General Symptoms of Anxiety Physical Cardiovascular: palpitations, chest pain, rapid heartbeat, flushing Respiratory: hyperventilation, shortness of breath Neurological: dizziness, headache, sweating, tingling and numbness

79 79 General Symptoms of Anxiety Physical Gastrointestinal: choking, dry mouth, nausea, vomiting, diarrhea Musculoskeletal: muscle aches and pains (esp. neck, shoulders), restlessness, tremors and shaking

80 80 General Symptoms of Anxiety Psychological Unrealistic and/or excessive fear and worry (about past or future events) Mind racing or going blank Decreased concentration and memory

81 81 General Symptoms of Anxiety Psychological Difficulty making decisions, confusion Restlessness, feeling ‘on edge’ or nervousness Tiredness, sleep disturbances, vivid dreams Irritability, impatience, anger

82 82 General Symptoms of Anxiety Behavioural Avoidance of situations Obsessive or compulsive behaviour Distress in social situations Phobic behaviour

83 83 Types of Anxiety Disorders Generalized anxiety disorder (GAD) Panic disorder (with or without agoraphobia) Agoraphobia Social anxiety disorder (social phobia) Phobic disorders Obsessive-compulsive disorder (OCD) Post traumatic stress disorder (PTSD) Acute stress disorder

84 84 Do You Worry All the Time? Which problems have you had often over the last 6 months?  I never stop worrying about things big and small  I have headaches or aches and pains for no reason  I am tense a lot and have trouble relaxing  I have trouble keeping my mind on things

85 85 Do You Worry All the Time? Which problems have you had often over the last 6 months?  I get crabby or grouchy  I have trouble falling asleep or staying asleep  I sometimes have a lump in my throat or feel like I need to throw up when I am worried  I sweat and have hot flushes

86 86 Generalized Anxiety Disorder (GAD) Overwhelming and unfounded anxiety Physical and psychological symptoms of anxiety and tension for more than 6 months General worries over money, health and family etc. even when no problem exists

87 87 Do You Have Sudden Bursts of Fear for No Reason? Which problems have you had during these bursts of fear?  I have chest pains or a racing heart  I have a hard time breathing or a choking feeling  I feel dizzy, or I sweat a lot  I have stomach problems or feel like I need to throw up

88 88 Do You Have Sudden Bursts of Fear for No Reason? Which problems have you had during these bursts of fear?  I shake, tremble, or tingle  I feel out of control  I feel unreal  I am afraid I am dying or going crazy

89 89 Panic Disorder A person with a panic disorder has panic attacks A panic attack is the sudden onset of intense fear or terror The attacks develop suddenly The fear is inappropriate for the circumstances in which it is occurring

90 90 Agoraphobia Fear of panic attacks Fear of being in a situation with no help or escape Avoidance of places where it is felt that a panic attack could happen

91 91 Do You Feel Afraid or Uncomfortable When You are Around Other People? Is it hard to be at work or school?  I have an intense fear that I will do or say something and embarrass myself in front of other people  I am always very afraid of making a mistake and being watched and judged by other people  My fear of embarrassment makes me avoid doing things that I want to do or speaking to people

92 92 Do You Feel Afraid or Uncomfortable When You are Around Other People? Is it hard to be at work or school?  I worry for days or weeks before I meet new people  I blush, sweat, tremble, or feel like I have to throw up before or during an event where I am with new people  I usually stay away from social situations such as school events and making speeches  I often drink to try and make these fears go away

93 93 Social Anxiety Disorder Common anxiety disorder Fear of humiliation, embarrassment or scrutiny by others Fear that others are thinking negatively about them Tends to develop in shy children as they move into adolescence

94 94 Phobic Disorders A person with a phobia avoids or restricts activities because of fear The fear appear persistent, excessive and unreasonable The fear will cause the person to avoid specific things, events or places

95 95 Have You Lived Through a Very Scary or Dangerous Event? Which problems have you had after the event?  I jump and feel very upset when something happens without warning  I have a hard time trusting or feeling close to people  I stay away from places that remind me of the event  I feel guilty because others died and I lived

96 96 Have You Lived Through a Very Scary or Dangerous Event? Which problems have you had after the event?  I have trouble sleeping and my muscles are tense  I feel like the terrible event is happening all over again. This feeling often comes without warning  I have nightmares and scary memories of the terrifying event  I get mad very easily

97 97 Post-Traumatic Stress Disorder and Acute Stress Disorder Post-Traumatic Stress Disorder (PTSD) and Acute Stress Disorder (ASD) occur after experiencing a distressing event ASD – distress is usually resolved within a month PTSD – distress lasts longer than a month

98 98 Do You Feel Trapped in a Pattern of Unwanted and Upsetting Thoughts? Are any of these problems interfering with your life?  I have upsetting thoughts or images enter my mind again and again  I feel like I can’t stop these thoughts or images, even though I want to  I worry a lot about terrible things that could happen if I’m not careful

99 99 Do You Feel Trapped in a Pattern of Unwanted and Upsetting Thoughts? Are any of these problems interfering with your life?  I have unwanted urges to hurt someone but know I never would  I have a hard time stopping myself from doing things again and again, like counting, checking on things, washing my hands, re-arranging objects, doing things until it feels right, collecting useless objects

100 100 Obsessive-Compulsive Disorder Obsessive thoughts and compulsive behaviours accompany feelings of anxiety. Obsessive thoughts are unwanted and inappropriate recurrent thoughts, impulses or images the person cannot get rid of. Compulsive behaviours are repetitive behaviours or mental acts such as counting, checking or washing.

101 101 Risk Factors for Anxiety Disorders Gender People with an anxious parent Difficult childhood (abuse, neglect) Some medical conditions Side-effects of some prescription drugs Some non-prescription drugs (caffeine, amphetamines, cocaine, etc.)

102 102 First Aid for Anxiety Disorders A ssess risk of suicide or harm L isten non-judgmentally G ive reassurance and information E ncourage the person to get appropriate professional help E ncourage self-help strategies

103 103 Step 1 Assess the Risk of Suicide or Harm People with anxiety disorders are at greater risk of dying by suicide, particularly if they also have depression. If you determine the person is at risk, follow the steps for Crisis First Aid for Suicidal Behaviour. If the person is not at risk, move on to Step 2 – Listen Non-Judgmentally.

104 104 Crisis First Aid for Panic Attacks 1.If you are unsure if it is a panic attack or a heart attack call an ambulance. 2.If you are sure it is a panic attack, move the person to a quiet safe place. 3.Help calm the person by helping them control their breathing. 4.Be a good listener, without judging.

105 105 Crisis First Aid for Panic Attacks 5.Explain they are having a panic attack and it is not life threatening. 6.Explain the attack will be over soon and they will recover. 7.Assure them that someone will stay with them until the attack stops.

106 106 Crisis First Aid for Acute Stress Reaction 1.Let the person tell their story but do not push them to do so. 2.Be a patient and sympathetic listener. 3.Reassure the person that stress reactions are normal responses to abnormal events and in time most people have a normal recovery of their emotions.

107 107 Crisis First Aid for Acute Stress Reaction 4.Encourage the person to share feelings with others. 5.Advise the person not to use alcohol or drugs to cope. 6.If the stress reaction persists for more than a month, encourage the person to seek professional help.

108 108 Step 2 Listen Non-Judgmentally YOU ARE NOT LISTENING TO ME WHEN: You say you understand. You say you have an answer to my problem, before I’ve finished telling you my problem. You cut me off before I’ve finished speaking. You finish my sentences for me.

109 109 Step 2 Listen Non-Judgmentally YOU ARE NOT LISTENING TO ME WHEN: You are dying to tell me something. You tell me about your experiences, making mine seem unimportant. You refuse my thanks by saying you really haven’t done anything.

110 110 Step 2 Listen Non-Judgmentally YOU ARE LISTENING TO ME WHEN: You try to understand me, even if I’m not making much sense. You grasp my point of view, even when it’s against your own sincere convictions. You realize the hour I took from you has left you a bit tired and a bit drained.

111 111 Step 2 Listen Non-Judgmentally YOU ARE LISTENING TO ME WHEN: You allow me the dignity of making my own decisions, even though you think they may be wrong. You do not take my problem from me, but allow me to deal with it in my own way. You hold back the desire to give me good advice.

112 112 Step 2 Listen Non-Judgmentally YOU ARE LISTENING TO ME WHEN: You do not offer me religious solace when I am not ready for it. You give me enough room to discover for myself what is really going on. You accept my gratitude by telling me how good it makes you feel to know that you have been helpful.

113 113 Step 3 Give Reassurance and Information Anxiety is a real medical condition. An anxiety disorder is a common illness. An anxiety disorder is not a weakness or character defect. Effective help and treatments are available. Anxiety can be unpleasant but is rarely harmful.

114 114 Step 4 Encourage the Person to Get Appropriate Professional Help Family doctor or physician Counselling or psychotherapy for specific anxiety disorder

115 115 Step 5 Encourage Self-Help Strategies Anxiety is best overcome by confronting fear rather than avoiding it Use evidence-based self help books Practice daily relaxation methods to reduce physical symptoms of tension Exercise regularly and get enough sleep Reduce caffeine intake Engage in leisure time

116 116 What Helps for Anxiety Disorders? Generalized anxiety disorderPhysical exercise Generalized anxiety disorder Specific phobias Anxiety Disorder Acupuncture Relaxation training CBT self-help books RatingTreatments

117 117 What Helps for Anxiety Disorders? Generalized anxiety disorderMeditation Range of anxiety disorders Generalized anxiety disorder Anxiety Disorder Alcohol Avoidance Relaxing Music RatingTreatments

118 118 Resources Refer to MHFA Canada Manual Section 3, page 10

119 119 Session 4 What are psychotic disorders? Symptoms of psychotic disorders Risk factors for psychosis Alcohol, drugs and psychotic disorders Crisis first aid for acute psychosis Mental health first aid for psychosis Treatment and resources Other expressions of distress

120 120 What is Psychosis? Psychosis is a mental health problem in which a person has lost some contact with reality Severe disturbances in thinking, emotion and behaviour Psychotic illnesses are not common compared to other mental health problems

121 121 What is Psychosis? Psychosis may appear as a symptom in a number of mental health problems including: –Schizophrenia –Schizoaffective disorder –Brief psychotic disorder –Psychotic disorder due to a general medical condition –Substance induced psychotic disorder

122 122 Symptoms of Psychosis Changes in emotion and motivation Depression or anxiety Suspiciousness Blunted, flat or inappropriate emotion Irritability Change in appetite Reduced energy and motivation

123 123 Symptoms of Psychosis Changes in thinking and perception Difficulties concentrating Sense of alteration of self or others – feeling that self or others have changed or are acting differently Odd ideas Unusual perceptual experiences – reduced or greater intensity of smell, sound, colour

124 124 Symptoms of Psychosis Changes in behaviour Sleep disturbance Social isolation or withdrawal Reduced ability to work or carry out social roles Odd or strange behaviour

125 125 Symptoms of Psychosis Changes in speech Disorganized speech Speech becomes rapid

126 126 Schizophrenia Schizophrenia is a chronic and disabling disorder Mental function changes and thoughts and perceptions become disordered Schizophrenia is not a constant or static condition – severity of symptoms fluctuate or do not appear at all

127 127 Symptoms of Schizophrenia Delusions Hallucinations Thinking difficulties Loss of drive Blunted emotions Social withdrawal

128 128 Other Psychotic Disorders Psychotic depression – a depression so intense it causes psychotic symptoms Schizoaffective disorder – Symptoms of both schizophrenia and mood disorder (depression, bipolar disorder) Substance induced psychosis – psychosis brought on by drug use. Drug use may also trigger another psychotic illness such as schizophrenia

129 129 Risk Factors for Psychotic Disorders It is believed that psychosis is caused by a combination of factors including: Genetics Biochemistry Stress

130 130 First Aid for Psychotic Disorders A ssess risk of suicide or harm L isten non-judgmentally G ive reassurance and information E ncourage the person to get appropriate professional help E ncourage self-help strategies

131 131 Step 1 Assess the Risk of Suicide or Harm Psychotic disorders involve high risk of suicide If you determine the person is at risk, follow the steps for Crisis First Aid for Suicidal Behaviour If the person is not at risk, move on to Step 2 – Listen Non-Judgmentally

132 132 What if a Psychotic Person is Threatening Violence? 1.Do not get involved physically 2.Call the police 3.Try to create a calm, non-threatening atmosphere 4.Try to get the person to sit down 5.Do not try to reason with acute psychosis 6.Express empathy for the person’s emotional distress 7.Comply with reasonable requests

133 133 Step 2 Listen Non-Judgmentally Listen to the person without judging Speak calmly, clearly and in short sentences Do not be critical of the person and do not express frustration with the person Do not give glib advice such as ‘pull yourself together’

134 134 Step 2 Listen Non-Judgmentally Avoid confrontation unless necessary to prevent harmful acts Do not argue with the person about their delusions and hallucinations but do not pretend they are real to you

135 135 Step 3 Give Reassurance and Information When a person is in a psychotic state it is difficult and inappropriate to give them information about psychosis – wait until they are in touch with reality Do not make promises you cannot keep and do not lie

136 136 Step 3 Give Reassurance and Information When the person is thinking more clearly explain: –You want to help them –They have a real medical condition –Their condition is not a common illness but well known and researched –Psychosis is not a weakness or character defect –Effective medications are available

137 137 Step 4 Encourage the Person to Get Appropriate Professional Help Early intervention is important. The person needs to be placed on appropriate medication –Family doctor or physician –Psychiatrist –Community mental health teams –Family and friends

138 138 Step 5 Encourage Self-Help Strategies Have an agreement with family/friends Many people with a psychotic disorder also have depression and/or anxiety The self-help strategies for these conditions may help but should not be the main source of treatment

139 139 Resources Refer to MHFA Canada Manual Section 4, page 8


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